Provider Demographics
NPI:1588824106
Name:KOTCHER, MARILYN (LCSW)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:KOTCHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 W 67TH ST APT 22D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6057
Mailing Address - Country:US
Mailing Address - Phone:201-390-8577
Mailing Address - Fax:
Practice Address - Street 1:14 HARWOOD CT STE 214
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4120
Practice Address - Country:US
Practice Address - Phone:845-362-2343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR028409-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical